Women's drug injection practices in East Harlem: an event analysis in a high-risk community

This study described the most recent injection events of injection-drug-using women, determined the prevalence of HIV, hepatitis B (HBV), and hepatitis C (HCV), and identified significant predictors of injection-related risk behaviors. After validation of drug use, 185 street-recruited women participated in structured interviews and were offered HIV, HBV, and HCV testing and counseling. Interview topics included (1) demographic characteristics, (2) characteristics of injection partners (IPs), and (3) relevant situation-specific factors. Prevalence was 28% for HIV infection, 80% for HBV, and 70% for HCV. Injection events were either solitary (n = 110) or social (n = 75). Most were safe, and 75% of syringes used were obtained from a syringe exchange. Inferential analyses identified two variables that independently predicted unsafe events: (1) respondent had injected previously with her IP, and (2) her IP was her spouse or primary heterosexual partner. Two trends were identified: Injection events in which women felt "very close" to their IP or reported lack of control over injection practices tended to be unsafe. Although most events were safe, safe practices were not adhered to with spouses or primary partners. Syringe exchanges should be supported and may be an ideal setting for interventions targeted to drug-injecting couples.